Click to download
Multiple Drug Intolerance Syndrome: a large-scale retrospective study Aim: To identify patient factors that could increase the risk of multiple drug intolerance syndrome (MDIS), identified as three or more drug allergy entries, in order to facilitate recognition of this condition in clinical practice. Method: Using a locally-developed electronic prescribing system, in-patient records with at least one documented drug allergy were reviewed over a five-year period. Data on demographics, medical history and drug history were collected and compared between MDIS and non-MDIS patients (one or two reported drug allergies). Univariate analysis was used to compare the rates across age, gender, weight, ethnicity, history of atopy, history of psychological disorders and previous in-patient admissions. Deprivation was also calculated from collected postcodes and compared between groups. Results: MDIS patients were found to be significantly older (median = 60 vs. 56 years, p<0.001), lighter in body weight (median=71.2 kg vs. 74.0 kg, p<0.001), more likely to be female (6.1% vs. 2.9%, p<0.001) and had more documented comorbidities (p<0.001) compared to non-MDIS patients. The presence of an atopic or psychological comorbidity were not significant risk factors for MDIS (p=0.444 and p=0.951 respectively). In addition, deprivation scores did not differ significantly between both groups (both medians= 0.17, p=0.214). With the exception of penicillin (p=0.749), cases of MDIS were significantly more frequent in those with recorded allergies to the 18 drug groups investigated (p<0.001). Conclusion: We identified key risk factors associated with high MDIS prevalence: older age, female gender, multiple comorbidities and high healthcare use. We also found that the propensity for different drug allergies to increase the likelihood of MDIS varies and that penicillin allergies do not share this relationship.
|
